| NPI | 1972069045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1315839) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-06-22 |