| NPI | 1497855522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT808) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT0655) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TN PT808) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: MS PT0655) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |