| NPI | 1164968061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62352) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: CA 292334) | |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2020-01-09 |