| NPI | 1124235718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT007848L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT007848l) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-04-16 |