| NPI | 1306262266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1234240) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-6114) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |