| NPI | 1396030128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18968) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT26379) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2025-08-25 |