| NPI | 1770011405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32561) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17164) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-07-10 |