| NPI | 1982024063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL 16249) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL 16249) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2020-09-09 |