| NPI | 1912512815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1333839) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1333839) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2022-07-24 |