| NPI | 1407804776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 19722) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 19722) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-08-23 |