| NPI | 1851961650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC PT10736) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT015274) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-06-25 |