| NPI | 1780895664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009038)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT22816)  | 
| Enumeration Date | 2007-05-24 | 
| Last Update Date | 2010-12-14 |