| NPI | 1003157892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 292107) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24402) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2020-04-01 |