| NPI | 1184891509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 21963) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 19792) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2023-07-10 |