| NPI | 1861613440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204684) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: VA 2305204684) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-07-15 |