| NPI | 1740691419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012396) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2021-12-27 |