| NPI | 1023431301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004850) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1479) |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: IA 004850) | |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2016-03-14 |