| NPI | 1124479605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-04984) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2014039418) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-11-30 |