| NPI | 1770712853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012279) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL 1595) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2018-10-26 |