| NPI | 1124506977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60797098) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62428) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2022-12-02 |