| NPI | 1013008564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT019824) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT21002) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2010-03-03 |