| NPI | 1710234414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 7647) |
| Additional Taxonomies | 251E00000X Home Health (Licence: TN 7647) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-20 |