| NPI | 1578733754 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010466) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 6592) | 
| Enumeration Date | 2008-03-04 | 
| Last Update Date | 2024-08-19 |