| NPI | 1942652995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61693) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60665104) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-07-01 |