| NPI | 1477634970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1184808) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 5182) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-05-19 |