| NPI | 1831487412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT5947) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 3411) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |