| NPI | 1639431752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 27403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0014384) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-03-25 |