| NPI | 1013204114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT16484) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL PT 16484) |
| Enumeration Date | 2011-07-09 |
| Last Update Date | 2011-07-27 |