| NPI | 1306450143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC P21414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 36297) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-10-18 |