| NPI | 1174801096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1185228) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26051) |
| 225100000X Physical Therapist (Licence: WI 11831-024) | |
| 225100000X Physical Therapist (Licence: TN 0000008614) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |