| NPI | 1063962108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT6023715) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK PHYP1707) |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-6221) | |
| 225100000X Physical Therapist (Licence: MA 7015) | |
| 225100000X Physical Therapist (Licence: ID PT-1966) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2024-03-01 |