| NPI | 1972096675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60854381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11078) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |