| NPI | 1134528656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2014019530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014019530) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2014-08-20 |