| NPI | 1740549641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT001890) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1415) |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC 3577) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2024-02-02 |