| NPI | 1063430007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1103612) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1103612) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-04-11 |