| NPI | 1396831061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011776) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 4381-024) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-03-17 |