| NPI | 1497186894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60756) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 4964210-2401) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2014-09-29 |