| NPI | 1144573031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1217760) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002785) |
| 225100000X Physical Therapist (Licence: FL PT27974) | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2022-01-06 |