| NPI | 1407292055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 28138) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT 010785) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |