| NPI | 1063572808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA 6052) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 6052) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2009-06-01 |