| NPI | 1659505352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2009004341) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: KS 11-04219) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2013-11-15 |