| NPI | 1679008445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32106) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305211596) |
| 225100000X Physical Therapist (Licence: NC 16830) | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2021-06-01 |