| NPI | 1871807271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1174312) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2016-02-01 |