| NPI | 1154864130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010197) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT21587) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2022-10-12 |