| NPI | 1053699769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SD 2099) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT60176774) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2018-09-14 |