| NPI | 1699917393 |
|---|---|
| Former Name | MICHELLE LARA DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60655153) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35559) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2019-10-07 |