| NPI | 1619166949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 37420) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 19223) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2023-04-24 |