| NPI | 1972742971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT25217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009538) |
| 225100000X Physical Therapist (Licence: SC 5870) | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2012-05-21 |