| NPI | 1164584314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 7374) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 7374) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2012-04-10 |