| NPI | 1750621439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1240567) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK PT 4339) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2014-03-27 |