| NPI | 1609094556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: PA DAPT001387) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT016231) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-07-23 |