| NPI | 1275914459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007971) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05009355A) |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2020-09-19 |