| NPI | 1609317213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MD 23333) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23333) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2019-05-08 |