| NPI | 1407125602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070019690) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3029) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2013-02-20 |