| NPI | 1679112031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT0000003326) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 39641) |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2025-02-17 |