| NPI | 1275909343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209760) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2018-01-08 |