| NPI | 1629132147 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1044246) | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1044246) | 
| Enumeration Date | 2006-12-20 | 
| Last Update Date | 2011-03-16 |