| NPI | 1891069167 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P13567)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NC P13567)  | 
| Enumeration Date | 2012-03-02 | 
| Last Update Date | 2013-01-29 |