| NPI | 1467859033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 34933) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TX 1252236) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2022-06-15 |