| NPI | 1083746218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT35758) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305006319) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2023-01-23 |