| NPI | 1518411180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61665) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: OR 61665) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2020-09-28 |