| NPI | 1932342342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29087) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009221) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT29085) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2019-01-24 |