| NPI | 1215036751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2623) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 783) |
| 225100000X Physical Therapist (Licence: MA 10338) | |
| 225100000X Physical Therapist (Licence: CO PTL.0003243) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: AK 783) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: OR 2623) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0003243) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-06-22 |