| NPI | 1497093066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT 00009622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR PT 3027) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |