| NPI | 1255860631 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT39706)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17431)  | 
| Enumeration Date | 2017-06-08 | 
| Last Update Date | 2023-09-26 |