| NPI | 1639482060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 6631) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 3169) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2013-09-19 |