| NPI | 1609269208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1258098) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 3116750) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-06-08 |