| NPI | 1598032120 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1236350) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011037089) | 
| Enumeration Date | 2011-11-28 | 
| Last Update Date | 2016-11-02 |