| NPI | 1912025206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MT PTP-PT-LIC-2287) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA PT00009521) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-12-14 |