| NPI | 1285939892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00006339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 3471) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |