| NPI | 1114635646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29777) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 08669) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-12-26 |