| NPI | 1174775530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1164370) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08079R) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2015-01-28 |