| NPI | 1861748261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 31774) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 4586) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2016-10-20 |