| NPI | 1497061360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PT25811) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 25811) |
| Enumeration Date | 2010-08-29 |
| Last Update Date | 2020-03-27 |