| NPI | 1356439103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1126365) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1126365) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-02-07 |