| NPI | 1184748105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22906) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 171W00000X Contractor (Licence: IN 05008245A) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-03-28 |