| NPI | 1851661219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1911) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT-00006519) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |