| NPI | 1558774505 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1143873)  | 
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 110387)  | 
| Enumeration Date | 2014-06-07 | 
| Last Update Date | 2014-06-07 |