| NPI | 1649799628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017560) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23201) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2025-02-20 |