| 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 |