| NPI | 1205899549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1226473) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 19019) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2015-11-02 |