| NPI | 1245755412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: MO 2017028629) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2017028629) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2018-01-16 |