| NPI | 1134413966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015040784) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005814) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-04-07 |