| NPI | 1053924639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT36990) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT36990) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT36990) | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2021-10-07 |