| NPI | 1306136973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA Pending) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2020-08-03 |