| NPI | 1891919957 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008900)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH4928)  | 
| 225100000X Physical Therapist (Licence: WA PT00009813)  | |
| Enumeration Date | 2007-04-12 | 
| Last Update Date | 2007-07-08 |