| NPI | 1679117147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251N0400X Physical Therapist, Neurology | |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |