| NPI | 1972378180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WI 16585) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15858) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2025-06-24 |