| NPI | 1407850092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT11757) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MT27143) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2007-07-09 |