| NPI | 1235243296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2036) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00006261) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |