| NPI | 1881889640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 9171) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT23644) |
| 225100000X Physical Therapist (Licence: TX 1187900) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2013-03-15 |