| NPI | 1356853931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: GA 013058) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1317282) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2019-06-11 |