| NPI | 1548591183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6131) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA 60167341) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2012-10-29 |