| NPI | 1699178038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT34381) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA24878) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-02-06 |