| NPI | 1679007918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP004669OT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014602) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2021-12-01 |