| NPI | 1356567382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305003368) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT2074) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: MD 16289) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |