| NPI | 1568706489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61569) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60687519) |
| 225100000X Physical Therapist (Licence: CA 36045) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-03-17 |