| NPI | 1215042031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: OK 4084) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT 2877) |
| 225100000X Physical Therapist (Licence: TX 1134344) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-06-25 |