| NPI | 1861776288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO 0012137) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 3369) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2019-09-18 |