| NPI | 1760680094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3625) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT 7678) |
| 225100000X Physical Therapist (Licence: SC PT 5250) | |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2007-07-09 |