| NPI | 1629058532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204677) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 9875) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-10-29 |