| NPI | 1306242219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1244250) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60230933) |
| 225100000X Physical Therapist (Licence: CO 7171) | |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |