| NPI | 1295377091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT24539) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL PT24539) |
| Enumeration Date | 2019-10-13 |
| Last Update Date | 2019-10-13 |