| NPI | 1073195509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: KY PT-005935) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: HI 771) |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2025-06-24 |