| NPI | 1184681504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AR PT2722) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AR PT2722) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2007-07-09 |