| NPI | 1144757808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT023875) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023875) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |