| NPI | 1932700739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: KY 008119) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008119) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2025-02-05 |