| NPI | 1649376690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22346) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: FL PT22346) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT22346) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2017-07-10 |