| NPI | 1639828221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: KY 008750) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004318) |
| 174N00000X Lactation Consultant, Non-RN | |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2024-05-19 |