| NPI | 1871864546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 9259) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305206925) |
| 225100000X Physical Therapist (Licence: MT 2469) | |
| 225100000X Physical Therapist (Licence: TX 1211567) | |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |