| NPI | 1982322848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2022030878) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2022030878) | 
| Enumeration Date | 2022-08-17 | 
| Last Update Date | 2025-09-11 |