| NPI | 1902969678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 025208 PT00006112) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: WA 025208 PT00006112) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: WA 025208 PT00006112) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |