NPI | 1124432604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT 30426) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305208799) |
Enumeration Date | 2014-06-12 |
Last Update Date | 2015-06-16 |