| NPI | 1790150589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 39895) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 19855) |
| Enumeration Date | 2015-12-06 |
| Last Update Date | 2023-02-15 |