| NPI | 1467852939 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 10963) | 
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NV 667) | 
| Enumeration Date | 2014-09-02 | 
| Last Update Date | 2014-09-02 |