| NPI | 1114166964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 21795) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT21795) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2025-01-22 |