| NPI | 1366623498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 4191) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 4191) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |