| NPI | 1376869909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: ND 1592) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8416) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2025-04-11 |