| NPI | 1477616639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60809015) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1164390) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-08-15 |