| NPI | 1497022164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010102) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P13412) |
| Enumeration Date | 2011-11-25 |
| Last Update Date | 2011-11-25 |