| NPI | 1285181719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60568573) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT 60568573) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-10-26 |