| NPI | 1053506642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1153301) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17994) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |