| NPI | 1124432604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12607) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305208799) |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: VA 2305208799) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-11-12 |