| NPI | 1174014203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62735) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1212156) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |