| NPI | 1417375932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1314156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 29198) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2019-05-07 |