| NPI | 1154756682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212969) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PTT28619) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT26379) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2021-10-13 |