| NPI | 1417909763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT004553)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT4063)  | 
| Enumeration Date | 2006-05-16 | 
| Last Update Date | 2008-07-17 |