| NPI | 1720393622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60279447) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: TX 1198721) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2019-02-22 |