| NPI | 1407521644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0017839) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008336) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-11-09 |