| NPI | 1902141815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT20471) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT7595) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2013-09-12 |