| NPI | 1891109443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP015418T) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX 1242741) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2022-10-26 |