| NPI | 1912068941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: OR 1953) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA 00002849) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |