| NPI | 1568721199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004963) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1216850) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |