| NPI | 1861266785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: HI PT-5804) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0017761) |
| Enumeration Date | 2023-11-10 |
| Last Update Date | 2023-11-10 |