| NPI | 1154371516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: NC 4397) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NC 4397) |
| 225100000X Physical Therapist (Licence: NC 4397) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-04-13 |