| NPI | 1275005217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH2604) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2018-12-31 |
| Last Update Date | 2018-12-31 |