| NPI | 1104257179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011308) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH7327) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2015-06-02 |