| NPI | 1538535141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60140713) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2564) |
| 225100000X Physical Therapist (Licence: ID PTDN-7701) | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2025-03-11 |