| NPI | 1770817900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1158008) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1158008) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2014-08-13 |