| NPI | 1093129215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208716) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60586426) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2022-04-01 |