| NPI | 1902238132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60293953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19534) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2013-07-30 |