NPI | 1306298443 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC PT 8191) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT31544) |
Enumeration Date | 2016-07-12 |
Last Update Date | 2017-12-13 |