| NPI | 1710251905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT27184) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010347) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |