| NPI | 1265607113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 4437) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 4437) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2011-03-30 |