| NPI | 1114474434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006920) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 006920) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2022-07-11 |