| NPI | 1972027423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60916100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62011) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2023-07-12 |