| NPI | 1336656297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63627) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NV 3143) | |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2021-08-16 |