| NPI | 1174844872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012751) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1194781) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2020-02-28 |