| NPI | 1154675775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT-27905) |
| 225100000X Physical Therapist (Licence: AR PT 4260) | |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2020-12-30 |