| NPI | 1316337108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1246431) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31311) |
| 225100000X Physical Therapist (Licence: WI 12956) | |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2018-05-31 |