| NPI | 1851644124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT00005175) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 13091) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |