| NPI | 1902974108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1173628) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT008493) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2011-07-18 |