| NPI | 1508995283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PR 810) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1112399) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2013-01-28 |