| NPI | 1619250495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT00008607) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT00008607) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |