| NPI | 1417102310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT0000007892) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204998) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2009-03-24 |