| NPI | 1750366415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH1103) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT0000001489) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2015-04-02 |