| NPI | 1497992143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 004547) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 24528) |
| Enumeration Date | 2009-01-17 |
| Last Update Date | 2009-01-17 |