| NPI | 1306193073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: LA 01919-R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 1544) |
| 225100000X Physical Therapist (Licence: LA 01919-R) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: OK 1544) | |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2021-04-12 |