| NPI | 1790255156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT015396) |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2023-12-01 |