| NPI | 1972584985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT17812) |
| Additional Taxonomies | 2251C2600X (Licence: FL PT 17812) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: FL PT 17812) | |
| 2251N0400X Physical Therapist, Neurology (Licence: FL PT 17812) | |
| 2251S0007X Physical Therapist, Sports (Licence: FL PT 17812) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT 17812) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2017-01-05 |