| NPI | 1417604406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR PT62455) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009924) |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |