| NPI | 1972622116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60100028) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: WA PT60100028) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-08-17 |