| NPI | 1609276658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1317020) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT - 3698) |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-7647) | |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2021-05-19 |