NPI | 1629600218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT028959) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NJ 40QA01964900) |
Enumeration Date | 2020-02-11 |
Last Update Date | 2023-07-18 |