| NPI | 1245512136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 00010789) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032096) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2021-02-17 |