| NPI | 1497886022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: LA 04211) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 04211) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-10-01 |