| NPI | 1154789006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT024101) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: PA PT024101) |
| Enumeration Date | 2016-02-07 |
| Last Update Date | 2016-02-15 |