| NPI | 1265624126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 8786) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017932) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2013-07-05 |