| NPI | 1669503884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO 0010498) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 2625) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2017-10-31 |