| NPI | 1780101675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P17583) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012855) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2019-05-03 |