| NPI | 1609060128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: WA PT00010573) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010573) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2023-11-14 |