| NPI | 1578694667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1172067) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1172067) |
| 222Q00000X Developmental Therapist (Licence: FL 30054) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-07-03 |