| NPI | 1508056201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1164500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 04451) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2007-07-29 |