| NPI | 1255773891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28097) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1229060) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2014-09-22 |