| NPI | 1316350093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH7161) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9937) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-12-18 |