| NPI | 1720634595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CO043379T) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL PT34950) |
| 225100000X Physical Therapist (Licence: TN 15519) | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2025-04-03 |