| NPI | 1578739660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010510) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 16862) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2016-07-07 |