| NPI | 1962954511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 11102) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2023-08-28 |