| NPI | 1558698522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 002832) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008825A) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2011-12-01 |