| NPI | 1639785199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 076165) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: MN 10750) |
| 2251P0200X Physical Therapist Pediatrics (Licence: IA 076165) | |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2024-02-06 |