| NPI | 1740606722 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35127) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 41154) | 
| Enumeration Date | 2014-03-13 | 
| Last Update Date | 2021-09-28 |