| NPI | 1720154925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 22495) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1090) |
| 225100000X Physical Therapist (Licence: TN 7717) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-11-06 |