| NPI | 1104230713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 2103589) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 4052492) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-07-28 |