| NPI | 1649500679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1104164) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: TX 1104164) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2014-08-12 |