| NPI | 1972842466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT0000008396) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010532) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |