| NPI | 1205353992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL FL36909) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305211058) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2021-03-30 |