| NPI | 1033321070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT23405) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2012) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-01-07 |