| NPI | 1255734083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: MA 18735) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: CA 33190) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |