| NPI | 1679025316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18020) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61841) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NC P18020) | |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2021-09-07 |