| NPI | 1174169072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1359162) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5400) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2022-05-12 |