| NPI | 1730627423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61459977) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22722) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2024-10-15 |