| NPI | 1376161638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021006417) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070.025209) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2023-06-27 |