| NPI | 1952759896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 9823068-2401) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: UT 9823068-2401) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-12-07 |