| NPI | 1255786174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12588) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30013) |
| 225100000X Physical Therapist (Licence: GA PT016334) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-12-23 |