| NPI | 1699317420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT872550) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305210014) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |