| NPI | 1730398751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT017474) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 031900-1) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-04-05 |