| NPI | 1104240878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19965) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9919) |
| 225100000X Physical Therapist (Licence: GA PT011846) | |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2023-03-08 |