| NPI | 1790863207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009183) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4940) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-08-27 |