| NPI | 1407245970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1269916) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29445) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2016-01-24 |