| NPI | 1962564120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 1908) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: AZ 1908) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-09 |