| NPI | 1396297230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11333) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA 11333) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TX 2123023) | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2022-12-05 |