| NPI | 1124413315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2013004050) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT011067) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |