| NPI | 1003155326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 2092180) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 10049) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |