| NPI | 1902379316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008629) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2023-01-06 |