| NPI | 1295035376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1199770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002565) |
| Enumeration Date | 2010-10-23 |
| Last Update Date | 2010-10-23 |