| NPI | 1356591176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1079770) |
| Additional Taxonomies | 111NR0400X (Licence: TX 4863) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2008-12-02 |