NPI | 1003452855 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT35472) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT028233) |
Enumeration Date | 2019-11-26 |
Last Update Date | 2024-07-07 |