| NPI | 1770788994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 05265) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010325) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2012-12-12 |