| NPI | 1073606349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05001893A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 001247) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05001893A) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: KY 001247) | |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2007-07-09 |