| NPI | 1649380999 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1116903) | 
| Additional Taxonomies | 225100000X Physical Therapist | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2012-11-30 |