| NPI | 1861423782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT 5144) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO PT 103140) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-02-11 |