| NPI | 1790114031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60130866) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2023-02-22 |