| NPI | 1740310275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1-7052-2) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: ME PT1246) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |