| NPI | 1619364627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT005949) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 5949) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2022-04-26 |