NPI | 1578041224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: AR 5263) |
Additional Taxonomies | 225100000X Physical Therapist |
2255A2300X Specialist/Technologist Athletic Trainer (Licence: TX 5300) | |
Enumeration Date | 2018-08-04 |
Last Update Date | 2023-04-14 |