| NPI | 1467996298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210201) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT31991) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2021-03-22 |