| NPI | 1144824350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 35943) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL 35943) |
| Enumeration Date | 2020-11-28 |
| Last Update Date | 2021-10-21 |