| NPI | 1639298789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008674) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT14809) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |