| NPI | 1386856706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1171828) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10729) |
| 225100000X Physical Therapist (Licence: GA PT005262) | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-12-01 |