| NPI | 1972053585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-30111) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61922) |
| 225100000X Physical Therapist (Licence: WA PT60698377) | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2018-06-24 |