| NPI | 1821224395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT23989) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PT18650) |
| 225100000X Physical Therapist (Licence: NC PT11657) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |