| NPI | 1790819936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT27119) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT007712) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2018-10-08 |