| NPI | 1629750872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: DE 0014868) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22498) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: PA 032210) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-09-27 |