| NPI | 1811349459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012681) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05488) |
| 225100000X Physical Therapist (Licence: MO 2016032645) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-11-14 |