| NPI | 1932332566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008530) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WA PT00008530) |
| 2251S0007X Physical Therapist, Sports (Licence: WA PT00008530) | |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2014-10-28 |