| NPI | 1598074072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23273) |
| 225100000X Physical Therapist (Licence: DE J1-0002302) | |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2016-03-08 |