| NPI | 1588706709 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 22947)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1023083)  | 
| 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT871219)  | |
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2011-05-25 |