| NPI | 1790923001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P11588) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2021-11-04 |