| NPI | 1962685941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60096531) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT60096531) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2019-02-25 |