| NPI | 1487062410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 9982) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4483) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2017-04-17 |