| NPI | 1619095346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P11019) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 003960) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: OH 009103) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-05-04 |