| NPI | 1306153754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4018) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19218) |
| 225100000X Physical Therapist (Licence: TX 1201028) | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2014-07-10 |