| NPI | 1902272768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL 36426) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008710) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2021-09-22 |