| NPI | 1922158377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: OR 01557) |
| Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: WA WAPT0000574) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2024-06-19 |