| NPI | 1407414105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007731) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KY TP2019035) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-03-23 |