| NPI | 1114776861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 009107) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY TP2024037) |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-08-20 |