| NPI | 1861614455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT28149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 15053) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-01-17 |