| NPI | 1073886487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05010733A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005996) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2018-03-12 |