| NPI | 1609252055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT5707) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 11162) |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2019-01-30 |