| NPI | 1386790947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013137) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 25186) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-07-21 |