| NPI | 1215355987 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29086) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 9976) | 
| 225100000X Physical Therapist (Licence: TX 1241350) | |
| Enumeration Date | 2014-03-31 | 
| Last Update Date | 2018-03-17 |