| NPI | 1972584522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015078) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 5651) |
| 225100000X Physical Therapist (Licence: TN PT0000005651) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2021-03-15 |