| NPI | 1467798595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1062735) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204256) |
| 225100000X Physical Therapist (Licence: WA 60172416) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2016-02-16 |