| NPI | 1992267876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60941291) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT34419) |
| 225100000X Physical Therapist (Licence: NM PT5468) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2020-12-10 |