| NPI | 1558568105 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070.014142) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.014142) | 
| Enumeration Date | 2007-06-28 | 
| Last Update Date | 2013-03-25 |