| NPI | 1063791150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26695) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT4387) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |