| NPI | 1497057186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1190426) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2493) |
| 225100000X Physical Therapist (Licence: IA 004599) | |
| 225100000X Physical Therapist (Licence: CA 35608) | |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |