| NPI | 1871788984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1091510) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60112611) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2020-06-26 |