| NPI | 1619379716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT011894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29696) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2018-10-15 |