| NPI | 1538376652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 23108) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21916) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2013-08-02 |