| NPI | 1639393218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05005392A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 003195) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05005392A) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: KY 003195) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-08 |