| NPI | 1962805994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29167) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009922) |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2014-10-05 |