| NPI | 1568422616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT30765) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL AL2451) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2017-01-16 |