| NPI | 1760807317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7265) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 7265) |
| 225100000X Physical Therapist (Licence: GA PT013300) | |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2018-03-19 |