| NPI | 1538314489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT711) | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MD 16339) | 
| 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305001401) | |
| Enumeration Date | 2008-11-19 | 
| Last Update Date | 2008-11-19 |