| NPI | 1295079754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 27194) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT 021825) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2022-05-02 |