| NPI | 1649656802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 13498PT) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT012014) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2018-03-17 |