| NPI | 1518095207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1205103)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT21634)  | 
| Enumeration Date | 2007-03-02 | 
| Last Update Date | 2019-11-05 |