| NPI | 1639510282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AL PTH6802) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT26720) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-12-05 |