| NPI | 1619493475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18670) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2023-01-19 |