| NPI | 1679829790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT27589) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2016-08-18 |