| NPI | 1649778978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT-008507) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-5499) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2022-07-17 |