| NPI | 1093488678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 009305) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KY A04253) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-05-14 |