| NPI | 1104276096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 33252) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1000) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2018-05-01 |