| NPI | 1184895591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 12009) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205249) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2009-12-08 |