| NPI | 1245510650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20019) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT26723) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2012-09-27 |