| NPI | 1366680316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1188573) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT019500) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-07-31 |