| NPI | 1396183604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011520) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6547) |
| Enumeration Date | 2013-06-08 |
| Last Update Date | 2015-03-05 |