| NPI | 1649460155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT00007305) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00007305) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2012-02-10 |