| NPI | 1194973552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT3757) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004646) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NM 3757) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2024-04-11 |