| NPI | 1730576497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P160067841) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA P160067841) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-05-27 |