| NPI | 1932759065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60994965) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT6293) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |