| NPI | 1427242999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT10512) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH5121) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2011-12-30 |