| NPI | 1518028588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT23307) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL PT23307) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2013-07-22 |