| NPI | 1649313321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NE 2941) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 112162) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2010-11-24 |