| NPI | 1831222363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 00476) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 00476) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: MO 00476) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-05-11 |