| NPI | 1306970850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22099) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2019-08-21 |