| NPI | 1962543074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL0011182) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2002018263) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2016-04-01 |