| NPI | 1629367735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT0183) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MS PT0183) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2014-03-21 |