| NPI | 1174575260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL 17965) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL pt17965) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-02-04 |