| NPI | 1841579711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT 60688756) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA 35246) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2016-11-16 |