| NPI | 1760771745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06243) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1197470) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2013-09-26 |