| NPI | 1033569561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 22120) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023869) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |