| NPI | 1700188661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V7210) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1185010) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2025-06-18 |