| NPI | 1578647756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305205896) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 7249) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2014-03-10 |