| NPI | 1649317348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005176) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WA 5176) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-01-28 |