| NPI | 1568837227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60964150) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 43313) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2019-10-30 |