| NPI | 1003275918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: IL 070.021975) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: MO 2010028891) |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2016-02-19 |