| 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 |