| NPI | 1134234743 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11260)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 003722)  | 
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2008-08-21 |