| NPI | 1306399423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017463) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31520) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-11-05 |