| NPI | 1124121736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1041200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 630) |
| 2251P0200X Physical Therapist Pediatrics (Licence: TX 1041200) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: AR 630) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |