| NPI | 1619169794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 8896) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27050) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2018-07-09 |