| NPI | 1376062430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09570R) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: LA 09570R) |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2017-09-10 |