| NPI | 1821146366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3018) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009569) |
| 2251X0800X Physical Therapist Orthopedic (Licence: OR 3018) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-10-31 |