| NPI | 1568946309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 20313) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: NC P20313) |
| 2251X0800X Physical Therapist Orthopedic (Licence: VA 2305212189) | |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2022-10-11 |