| NPI | 1508133216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 012235) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1204203) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2016-01-15 |