| NPI | 1770902017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT5851) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT011293) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2015-10-12 |