| NPI | 1558732651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2015016087) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-04861) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |