| NPI | 1609493626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014671) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT014671) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2023-08-28 |