| NPI | 1083159123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007004) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 16786) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2019-07-12 |