| NPI | 1598134157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1270002) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20188) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2017-02-01 |