| NPI | 1134327315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011831) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 6599616-2401) |
| 225100000X Physical Therapist (Licence: TN 10393) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-03-13 |