| NPI | 1679099402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 13242) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13242) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2022-05-31 |