| NPI | 1215519541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: AL PTH7896) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: AL PTH8769) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2021-04-26 |