| NPI | 1679155790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP008278T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P19302) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-10-25 |