| NPI | 1801831672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO 8269) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 002492) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2021-03-02 |