| NPI | 1710287156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28023) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6534) |
| 225100000X Physical Therapist (Licence: CO 10928) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2015-10-01 |