| NPI | 1649325465 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT41088)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 007968)  | 
| Enumeration Date | 2007-01-24 | 
| Last Update Date | 2024-06-11 |