NPI | 1174299341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11952) |
225100000X Physical Therapist (Licence: TX 1350248) | |
Enumeration Date | 2021-08-18 |
Last Update Date | 2023-08-14 |