| NPI | 1659821767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 31269) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: FL 31269) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL 31269) | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2022-10-04 |