NPI | 1528368925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA 025882) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 37075) |
Enumeration Date | 2010-11-01 |
Last Update Date | 2017-03-09 |