| NPI | 1265803142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013800) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT 30869) |
| Enumeration Date | 2015-10-17 |
| Last Update Date | 2020-09-15 |