| NPI | 1407270341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 004579) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 90410R) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2019-01-23 |