| NPI | 1942603568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1242179) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 2679) |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2014-09-28 |