| NPI | 1376696377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21364) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT010049L) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2025-06-23 |