| NPI | 1497896005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00003899)  | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic | 
| 225100000X Physical Therapist (Licence: WA PT0003899)  | |
| Enumeration Date | 2007-02-08 | 
| Last Update Date | 2023-06-30 |