| NPI | 1114123551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00007734) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC NC00006636) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2007-07-08 |