| NPI | 1528101961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: ID PT-1861) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009360) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-12-21 |