| NPI | 1235776600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014582) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1326145) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2021-03-25 |