| NPI | 1750862686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013623) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9305) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2026-02-04 |