| NPI | 1225405996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25595) |
| 225100000X Physical Therapist (Licence: FL PT34799) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2020-10-30 |