| NPI | 1316082860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: NC 10917) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10917) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2011-07-29 |