| NPI | 1700286309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011698) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 0000009656) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2018-11-15 |