| NPI | 1902142060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 00009637) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1147140) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |