| NPI | 1174974745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT6063368) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60633687) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2022-03-23 |