| NPI | 1043493877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MS PT4292) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TN PT0000004903) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2008-07-01 |