| NPI | 1629441993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1260920) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 23674) |
| Enumeration Date | 2015-11-08 |
| Last Update Date | 2015-11-08 |