| NPI | 1639461700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2011012299) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-02760) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-06-19 |