| NPI | 1750931226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015994) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 044914) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-07-25 |