| NPI | 1154858801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26634) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26446) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2018-01-31 |