| NPI | 1073878203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305209066) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24064) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2014-10-13 |