| NPI | 1922399690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1198339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205435) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2014-04-17 |