| NPI | 1124457163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 8668359-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19274) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |