| NPI | 1134882699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61433593) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2024-12-05 |