| NPI | 1477921906 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AL PTH7184)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL pth7184)  | 
| Enumeration Date | 2015-09-15 | 
| Last Update Date | 2015-09-15 |