| NPI | 1891272597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60837937) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9868) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2020-07-01 |