| NPI | 1619280799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 13622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005636) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2012-11-29 |