| NPI | 1508026311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: LA 03723) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AL PTH4543) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2012-01-24 |