| NPI | 1548724230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1303490) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT2203) |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2019-01-26 |