| NPI | 1144634049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015806) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11152) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-09-09 |