| NPI | 1659692168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1196049) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 25152) |
| 225100000X Physical Therapist (Licence: NY 030990) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2010-06-18 |