| NPI | 1306066055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1049997) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX 1049997) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-09-19 |