| NPI | 1609227602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 1874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT003335) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-01-16 |