| NPI | 1265066658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 10133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC PT.10133) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2021-12-02 |