| NPI | 1407312473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 35654) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT014345) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2020-08-12 |