| NPI | 1760831531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1248499) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60633712) |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2016-06-12 |