| 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 |