| NPI | 1013435957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1296357) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: TX 1296357) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-05-11 |