| NPI | 1063827251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0012799) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1242377) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-11-04 |