| NPI | 1619012929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00002981) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: WA PT00002981) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2015-02-22 |