| NPI | 1679659221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT009001) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KY PT-004517) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |