| NPI | 1568523264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 07039R) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: LA 07039R) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-02-04 |