| NPI | 1396207908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT34494) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0003811) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |