| NPI | 1063072379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT36180) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT36180) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-11-06 |