| NPI | 1952654220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WA 00005178) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: ID 617) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |