| NPI | 1609347608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 10156) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MD 17037) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-09-11 |