| NPI | 1972101160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61021267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018608) |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2020-10-12 |