| NPI | 1508384074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT012873) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: GA PT012873) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |