| NPI | 1710655329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017524) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37476) |
| 225100000X Physical Therapist (Licence: DE J1-0014871) | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2024-12-30 |