| NPI | 1831462076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1062263) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1062263) | 
| Enumeration Date | 2012-02-20 | 
| Last Update Date | 2014-06-23 |