| NPI | 1821345000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013084) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9455) |
| 2251N0400X Physical Therapist, Neurology (Licence: FL 26810) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2019-02-27 |