| NPI | 1750834818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1830) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: TX 3120095) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2018-10-05 |