| NPI | 1053781831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1266499) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 05199) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2016-01-25 |