| NPI | 1982364972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61562314) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 28782) |
| Enumeration Date | 2021-12-18 |
| Last Update Date | 2024-05-16 |