| NPI | 1891813267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011803) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA002342) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-03-11 |