| NPI | 1396033569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1244873) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19622) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2017-11-01 |