| NPI | 1568891562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 28766) |
| 2251P0200X Physical Therapist Pediatrics (Licence: SC PT 7941) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: FL PT 28766) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2021-07-19 |