| NPI | 1952046351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 11633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007260) |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |