| NPI | 1033493465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1250222) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 22098) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2015-02-24 |