| NPI | 1821634924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60970748) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA 161035840) |
| Enumeration Date | 2019-11-23 |
| Last Update Date | 2021-05-24 |