| NPI | 1992198725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011849) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209287) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |