| NPI | 1265703755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007636) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011040561) |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2019-09-13 |