| NPI | 1194969964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT 2919) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT 873) |
| 225100000X Physical Therapist (Licence: GA PT2919) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: TN PT 873) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TN PT 873) | |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2019-03-13 |