| NPI | 1285789792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL PT5463) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 5463) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |