| NPI | 1679828685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT30891) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0347431) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2019-10-30 |