| NPI | 1225179054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT-004482) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 18094) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2008-02-01 |