| NPI | 1902295868 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: UT 9407490-2401)  | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT29639)  | 
| Enumeration Date | 2015-01-15 | 
| Last Update Date | 2017-02-01 |