| NPI | 1467508176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-00490) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2004034162) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2013-05-15 |