| NPI | 1598421802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015691)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37559)  | 
| Enumeration Date | 2021-11-10 | 
| Last Update Date | 2021-11-24 |