| NPI | 1104225929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC P15133) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT 29565) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2022-05-19 |