| NPI | 1164747283 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT870549) | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305204419) | 
| Enumeration Date | 2010-03-31 | 
| Last Update Date | 2010-10-20 |