| NPI | 1245456250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008345) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KY A02040) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-08-27 |