| NPI | 1619460920 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05012877A)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL FL30398)  | 
| Enumeration Date | 2018-06-11 | 
| Last Update Date | 2018-06-11 |