| NPI | 1851713911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207864) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1234387) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |