| NPI | 1790152361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 32983) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT32983) |
| 225100000X Physical Therapist (Licence: VA 2305209797) | |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2019-09-18 |