| NPI | 1861972994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 17225) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT013603) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2020-09-30 |