| NPI | 1982034062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT31388) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31388) |
| 225100000X Physical Therapist (Licence: AZ 10651) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2021-08-11 |