| NPI | 1114190618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: WI 1963-24) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MN 4572) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |