| NPI | 1639467848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1209155) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2022-08-03 |