| NPI | 1962618108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60360060) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10804-024) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2013-11-25 |