| NPI | 1083040893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007955) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PTT28680) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2021-09-10 |