| NPI | 1558591487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT4585) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8628) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2014-09-11 |