| NPI | 1750427910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 12329) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT 21200) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-02-29 |