| NPI | 1861720039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60122304) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR PT6129) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |