| NPI | 1942691068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4960 PT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT 002675) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |