| NPI | 1447637459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011012) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 8553) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2016-10-21 |