| NPI | 1790251932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 61034049) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: WA 61034049) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2020-12-08 |