| NPI | 1710046503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA 7123) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 7123) | 
| Enumeration Date | 2006-12-07 | 
| Last Update Date | 2017-03-22 |