| NPI | 1083248462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT007908) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0017143) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: KY PT-007908) | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2024-02-15 |