| NPI | 1861784654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60617628) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 12598) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2016-11-11 |