| NPI | 1265478317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004899) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-02-19 |