| NPI | 1982991535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015093) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306603034) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2021-06-09 |