| NPI | 1467955039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 295596) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1299216) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2021-01-05 |