| NPI | 1649639766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42630) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1243770) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |