| NPI | 1063691566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 06445) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: LA 06445) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2021-07-23 |