| NPI | 1487998753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 116591-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-559) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |