| NPI | 1780834424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 11840) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22711) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: SC 6526) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2013-09-25 |