| NPI | 1811761000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 12286) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22743) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2025-09-11 |