| NPI | 1639322159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 000310) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30062) |
| 225100000X Physical Therapist (Licence: IN 05001282A) | |
| 225100000X Physical Therapist (Licence: GA PT005973) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |