| NPI | 1366848921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29597) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.00012966) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2016-07-07 |