| NPI | 1568997971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT23276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT5587) |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2017-04-23 |