| NPI | 1659462893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1170710) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 19515) |
| 225100000X Physical Therapist (Licence: NJ 40QA00933200) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-12-12 |