| NPI | 1619290889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60002782) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8054) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2015-03-25 |