| NPI | 1255682951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT10948) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PTT27780) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2013-06-04 |