| NPI | 1043490626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 2067) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 2067) |
| 2251S0007X Physical Therapist, Sports (Licence: TN 2067) | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2018-07-17 |