| NPI | 1891273793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT33055) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13964) |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |