| NPI | 1760757967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012198) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA002491) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2015-11-24 |