| NPI | 1154566040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1128510) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1128510) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1128510) | |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2010-01-08 |