| NPI | 1811694359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT016432) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT40003) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2025-06-11 |