| NPI | 1760712418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1076727) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305006039) |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |