| NPI | 1629471362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 15200) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: TX 1249886) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2019-09-17 |