| NPI | 1730388323 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1177343) | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1177343) | 
| Enumeration Date | 2007-07-13 | 
| Last Update Date | 2023-08-21 |