| NPI | 1447261177 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 3809) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 3809) | 
| Enumeration Date | 2006-08-10 | 
| Last Update Date | 2021-05-12 |