| NPI | 1679228647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11117) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 11117) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-03-15 |