| NPI | 1972538619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN PT000000871) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN pt871) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-08-19 |