| NPI | 1396912382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: TN 5692) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 5692) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2009-04-16 |