| NPI | 1972141521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015059) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 017949) |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2021-03-26 |