| NPI | 1154897528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1348129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60833850) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2021-12-01 |