| NPI | 1629623988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY CP000440T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019030174) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |