| NPI | 1972664548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00336) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1027837) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-09 |