| NPI | 1114979291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1169317) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6930) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-07-07 |