| NPI | 1902294630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 00008505) |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access (Licence: WA 00008505) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |