| NPI | 1821563990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008208) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT22901) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-10-04 |