| NPI | 1134496854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007094) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: TX 1212496) |
| 2251N0400X Physical Therapist Neurology (Licence: TX 1212495) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: TX 1212495) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: TX 1212495) | |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2021-06-15 |