| NPI | 1326420837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60979906) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22000) |
| 225100000X Physical Therapist (Licence: MI 5501017215) | |
| 225100000X Physical Therapist (Licence: AK 142338) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2019-08-22 |