| NPI | 1962788653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60205685) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK PHYP2217) |
| 225100000X Physical Therapist (Licence: OR OR 60066) | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2016-12-20 |