| NPI | 1508295528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1064053) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01120) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-12 |