| NPI | 1881032472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT28598) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-4402) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-06-12 |