| NPI | 1851762850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1236180) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 41978) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2022-01-14 |