| NPI | 1063625457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 22588) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT 008172) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |