| NPI | 1730371493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT5090) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY PT004918) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2014-11-13 |