| NPI | 1740486869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA 60036266) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR T 5436) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2015-04-15 |