| NPI | 1629500202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1082428) |
| Additional Taxonomies | 2251C2600X (Licence: TX 1082428) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2017-04-01 |