| NPI | 1104295617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PTT30799) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: FL PTT30799) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2016-01-29 |