| NPI | 1295724961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2001020585) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-03086) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2007-07-08 |