| NPI | 1477067726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26408) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT011674) |
| Enumeration Date | 2017-11-24 |
| Last Update Date | 2017-12-28 |