| NPI | 1457481632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MD 17389) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501011127) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2015-02-18 |