| NPI | 1780939744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: UT 8317386-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8317386-2401) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2023-04-07 |