NPI | 1124562301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012710) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT17124) |
225X00000X Occupational Therapist (Licence: GA OT006462) | |
Enumeration Date | 2016-12-07 |
Last Update Date | 2021-06-28 |