| NPI | 1609099407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0011886) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1017598) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2013-03-07 |