| NPI | 1659509040 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1195456) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT24725) | 
| 225100000X Physical Therapist (Licence: WA PT60994978) | |
| Enumeration Date | 2009-06-24 | 
| Last Update Date | 2019-09-12 |