| NPI | 1104349596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 00736) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6263) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2018-10-12 |