| NPI | 1306352612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26935) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT27643) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2019-06-03 |