| NPI | 1992113203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1993) |
| Additional Taxonomies | 174400000X Specialist (Licence: ND 471-12) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: ND 1993) | |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2022-11-17 |