| NPI | 1710116827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT24083) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2012-02-10 |