| NPI | 1649409830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 00006177) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-653) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2019-10-11 |