| NPI | 1083010102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY CP000949T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR CP000918T) |
| 225100000X Physical Therapist (Licence: TN 10080) | |
| 225100000X Physical Therapist (Licence: CO PTL.0013872) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2019-12-24 |