| NPI | 1194236901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2017033644) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |