| NPI | 1982716767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005555) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: WA PT00005555) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-17 |