| NPI | 1578689543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1180340) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 8673) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-01-12 |