| NPI | 1053528414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 14498) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1148025) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2013-09-26 |