| NPI | 1700062544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1243740) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 027773-1) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2016-11-28 |