NPI | 1912964099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 3495) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 10730) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2007-07-09 |