| NPI | 1861881617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60405057) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20977) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-16 |