| NPI | 1417515149 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014560)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007272)  | 
| Enumeration Date | 2019-05-29 | 
| Last Update Date | 2022-11-29 |