| NPI | 1104974534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 10422) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10422) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2023-10-27 |