| NPI | 1720423965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 00008504) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-1614) |
| 225100000X Physical Therapist (Licence: MA 15588) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |