| NPI | 1851622385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1171443) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1171443) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2015-08-03 |