NPI | 1619289436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305208367) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT020669) |
Enumeration Date | 2010-07-09 |
Last Update Date | 2014-02-04 |