| NPI | 1972838712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 004604) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 113566) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2012-08-10 |