| NPI | 1912280447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT 29683) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT 20885) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2021-06-17 |