| 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 | 2025-03-19 |