| NPI | 1568938793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1323126) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007527) |
| 225100000X Physical Therapist (Licence: GA PT013323) | |
| 225100000X Physical Therapist (Licence: LA 09249R) | |
| 225100000X Physical Therapist (Licence: VA 2305207006) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2019-10-07 |