| NPI | 1215481767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35230) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22516) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2022-01-26 |