| NPI | 1124843032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2024044681) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2024044681) |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-12-05 |