| NPI | 1578863486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT706) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1098010) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2018-03-15 |