| NPI | 1891971990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1178778) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029782) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2011-12-30 |