| NPI | 1245689223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1275707) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0121257) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |