| NPI | 1033463716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61937) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006119) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2018-03-17 |