| NPI | 1386781854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NE 747) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MN 927) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |