| NPI | 1194196865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 10089) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 115063) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2021-01-28 |