| NPI | 1538535430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 08835R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1243099) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |