| NPI | 1811952203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1040160) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 11306) |
| 225100000X Physical Therapist (Licence: AZ 2859) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |