| NPI | 1720425796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006222) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05011091A) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2021-11-09 |