| NPI | 1083803605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1192880) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205166) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2015-03-23 |