| NPI | 1679928451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2015036953) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-05-08 |