| NPI | 1841033644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11764) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: NC P-CP031591T) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |