| NPI | 1952340556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009431) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 120102039) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |