| NPI | 1710165840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1178868) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 62 031440) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2010-10-07 |