| NPI | 1992702765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 5997) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT007773) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2011-06-13 |