| NPI | 1407278815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 28774) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: FL PT 28774) |
| 2251X0800X Physical Therapist Orthopedic (Licence: FL PT 28774) | |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2022-08-26 |