| NPI | 1790458891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10823) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2022-01-01 |