| NPI | 1063847887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT0000009458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6778) |
| 225100000X Physical Therapist (Licence: CO PTL0011914) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2013-09-11 |