| NPI | 1487030938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 003519) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006687) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2018-10-06 |