| NPI | 1164779625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO 9414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 9414) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2014-06-26 |