| NPI | 1104931690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1078095) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 8882) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2012-07-07 |