| NPI | 1629318050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008050) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT12101) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |