| NPI | 1164578217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 34060) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 11122) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 016883) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2010-09-16 |