| NPI | 1992960884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29105) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-1773) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2018-12-12 |