| NPI | 1114694353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015645) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P20737) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2022-05-27 |