| 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 |