| NPI | 1790066025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1209540) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 4455) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |