| NPI | 1811919822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1071314) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT22382) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-08-23 |