| NPI | 1962845776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 7740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009768) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |