| NPI | 1578291118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: OR 64648) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 64648) |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-06-18 |