| NPI | 1417472622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1296062) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1296062) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2018-05-08 |