| NPI | 1619276615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: WA MA00025104) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OR 13582) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2016-08-04 |