| NPI | 1598099889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 8548) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: FL 8548) |
| Enumeration Date | 2009-09-20 |
| Last Update Date | 2009-09-20 |