| NPI | 1053853101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT871950) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26265) |
| 225100000X Physical Therapist (Licence: VA 2305210754) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: SC 9054) | |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2018-05-08 |