| NPI | 1740384254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT35202) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR PT1942) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2022-03-08 |