| NPI | 1760044069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012704) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH9243) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |